Surgery Checklist
Please review the day before surgery.
Date of Surgery: ___________________________________________________
Day Before Surgery
____ 1. A nurse will call you by 2 pm the day before surgery or on Friday for a Monday surgery. She will tell you the time to check in and the time of surgery. If you do not get a phone call by 2 pmthe day before surgery, please call us:
_____ OutpatientSurgeryCenter 608-263-8804
_____ First Day Surgery Unit 608-265-8857
Toll Free: 1-800-323-8942. Ask for one of the above units.
____2. Follow the instructions given by the nurse about when to stop eating and drinking. If you did not get instructions, stop eating and drinking at midnight. This includes water.
____3. You must have someone drive you home from the hospital. If you take a bus or cab, you must have an adult with you.
____4. Plan to have a responsible adult stay with you the first night home from the hospital. You may not stay alone.
____5. Leave all rings and valuables at home. Only bring enough money to pay for medicine or other needs. Please do not bring extra clothes. We suggest that children be left at home if possible as they become easily bored and restless.
____6. Other instructions. (bowel prep)
_________________________________________
_________________________________________
_________________________________________
Morning of Surgery
____1. Take these medicines the morning of surgery. Take pills with a sip of water.
__________________________ _________________________
__________________________ _________________________
__________________________ _________________________
____2. You may need to give a urine sample when you check in.
____3. ____________________________________________
__________________________________________________
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 06/11/2009
Copyright © 06/11/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5687
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